| Name of
Company : * |
|
| Name of Contact
Person :* |
|
| Designation
: |
|
| Address : * |
|
| City : * |
|
| Pin Code : |
|
| State
: |
|
| (if Other State Please Specify:) |
|
| Country
:* |
|
| (if Other
Please Specify:) |
|
| Project
Name : |
|
| Engineer
: |
|
| Tel. No. : * |
|
| Fax No.
: |
|
| Email
: * |
|
| If existing
Program / manufacturer being used: |
| Manufacturer : * |
|
| Part
Number : |
|
| Applications
: |
|
|
Commercial
Medical
Military |
|
Quantity |
Date |
| Prototypes
: |
|
|
| Production
: |
|
|
|
|
| Input
Voltage : |
|
| Vac |
|
| Vdc |
|
| Power
Factor Correction |
Yes
No |
|
| Output |
Volts
(V) |
Amps
(A) |
Peak
Current
(A) |
Regulation
(+ / - / %) |
| V1 |
|
|
|
|
| V2 |
|
|
|
|
| V3 |
|
|
|
|
| V4 |
|
|
|
|
| V5 |
|
|
|
|
| V6 |
|
|
|
|
|
Mechanical
Information |
|
Open-Frame PCB |
|
Enclosed (sheet
metal enclosure) |
|
Table Top
(plastic table top) |
|
External Wall
Mount |
| Requirements
Details : * |
|